Individual
MAZEN KHERALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-7200
(701) 234-7225
Mailing address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-7200
(701) 234-7225
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
9502
ND
Other
Enumeration date
07/17/2006
Last updated
02/14/2021
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